Cholesterol, LDL, HDL, and Triglycerides in Children and Adolescents

Facts about cholesterol

Cholesterol is a fat-like, waxy substance that can be found in all parts of the body. It aids in the production of cell membranes, some hormones, and vitamin D. The cholesterol in blood comes from two sources: the foods your child eats and his or her liver. However, your child's liver can make all of the cholesterol your child's body needs.

Cholesterol and other fats are transported through the blood stream in the form of round particles called lipoproteins. The two most commonly known lipoproteins are low-density lipoproteins (LDL) and high-density lipoproteins (HDL).

What is LDL (low-density lipoprotein) cholesterol?

What is HDL (high-density lipoprotein) cholesterol?

This type of cholesterol is commonly called "bad" cholesterol. It can contribute to the formation of plaque build up in the arteries, known as atherosclerosis. People commonly refer to atherosclerosis as "blockages in my heart."

LDL levels should be low. To help lower LDL levels, help your adolescent:

  • Avoid foods high in saturated fat, dietary cholesterol, and excess calories in general

  • Increase exercise

  • Maintain a healthy weight

This type of cholesterol is known as "good" cholesterol, and is a type of fat in the blood that helps to remove cholesterol from the blood, preventing the fatty build up and formation of plaque in your blood vessels.

HDL should be as high as possible. It is often possible to raise HDL by:

  • Exercising for at least 20 minutes 3 times a week

  • Avoiding saturated fat intake

  • Decreasing body weight


What are triglycerides

Triglycerides are another class of fat found in the bloodstream. The bulk of your adolescent's body fat tissue is in the form of triglycerides.

The link between triglycerides and heart disease is under clinical investigation. However, many children and adolescents with high triglyceride levels also have other risk factors such as high LDL levels or low HDL levels.

What causes elevated triglyceride levels?

Elevated triglyceride levels may be caused by medical conditions such as diabetes, hypothyroidism, kidney disease, or liver disease. Dietary causes of elevated triglyceride levels may include obesity and high intakes of fat, alcohol, and concentrated sweets.

For adults, a healthy triglyceride level is less than 150 mg/dL.

Checking blood lipid levels

A lipid screening is an overall look at the fats in the blood. In the past, doctor's felt that children and adolescents were at little risk for developing high cholesterol levels and other risk factors for heart disease until later in life. However, we now know that children and adolescents are at risk for having high blood cholesterol levels as a result of one, or more of the following:

  • Sedentary lifestyles (playing video games, watching TV, not participating in vigorous exercise)

  • High-fat or high-sugar "junk food" diets

  • Obesity

  • Family history of high cholesterol levels

Children and adolescents with high cholesterol are at higher risk for developing heart disease as adults. Keeping blood cholesterol levels in the normal range throughout one's lifetime reduces the likelihood of developing heart and blood vessel diseases, such as coronary artery disease (blockages in the arteries that supply blood to your heart) and high blood pressure.

Lipid testing for children

Experts recommend that cholesterol testing be considered at a young age for any child who has the following:

  • At least one parent who has been found to have high cholesterol

  • A family history of early heart disease (before age 55 in a male parent or grandparent and before age 65 in a female parent or grandparent)

They also recommend that children and adolescents who have demonstrated risk factors, such as obesity, tobacco exposure, or diabetes, should have cholesterol and other lipids tested periodically. Routine screening is recommended between the ages of 9 and 11 years and again between the ages of 17 and 21 years, even in children and adolescents without risk factors present.

A full lipid profile shows the actual levels of each type of fat in the blood, such as LDL, HDL, triglycerides, and total cholesterol. Your child's doctor may recommend fasting before the blood test depending on the type of lipid panel needed. Your child's doctor can also tell you what the normal values should be for all the lipids after considering age and the number of risk factor's present.

What is a healthy blood cholesterol level?

Blood cholesterol is very specific to each person. A full lipid profile can be an important part of your adolescent's medical history and important information for your adolescent's doctor to have. In general, healthy levels are as follows:

  • LDL of less than 130 mg/dL

  • HDL of greater than 35 mg/dL (less than 35 mg/dL puts your adolescent at higher risk for heart disease)

The National Heart Lung and Blood Institute recommends the following guidelines for cholesterol levels in children and teenagers (ages 2 to 19) from families with high blood cholesterol or early heart disease:


Total cholesterol



Less than 170 mg/dL

Less than 110 mg/dL


170 to 199 mg/dL

110 to 129 mg/dL


200 mg/dL or greater

130 mg/dL or greater

Statistics about cholesterol

Elevated cholesterol is a risk for many Americans. Consider the following information from the CDC:

  • 13.4% of U.S. adults—or one in every six—have high total cholesterol.

  • The average cholesterol level for U.S. adults is 200 mg/dL.

Treatment of high cholesterol

If the results of your child's lipid tests are abnormal, your child's doctor will work closely with you to devise a treatment plan. Most children and adolescents will not need medication. Often, a healthy diet, weight loss, and increased physical activity are enough to return blood lipid levels to normal. Your child's doctor will continue to closely monitor any lipid levels that were abnormal and help your child make lifestyle changes. Your child's doctor will discuss medication with you when necessary.